Nur Intan Nasution, Nur Intan
Rumah Sakit Umum Daerah Cibabat Cimahi, Jl. Jend. Amirmachmud No. 140 Cimahi

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Jarak antara Saraf Femoralis dan Arteri Femoralis pada Daerah Lipat Inguinal Orang Dewasa dengan Menggunakan Pencitraan Ultrasonografi untuk Panduan Letak Penyuntikan Blokade Saraf Femoralis Nasution, Nur Intan; Yadi, Dedi Fitri; Nawawi, A. Muthalib
Jurnal Anestesi Perioperatif Vol 3, No 3 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Blokade saraf femoralis merupakan salah satu metode blokade saraf perifer yang digunakan untuk memfasilitasi operasi ekstremitas bawah. Blokade femoralis memiliki efek analgesia perioperatif yang efektif dengan sedikit efek samping sistemik, penurunan kebutuhan opioid serta mobilisasi lebih awal dan murah. Arteri femoralis digunakan sebagai penanda anatomis pada blokade saraf femoralis karena letaknya berdekatan dengan saraf femoralis. Penelitian ini bertujuan mengetahui jarak titik tengah saraf femoralis terhadap titik tengah arteri femoralis di daerah lipatan inguinal orang dewasa menggunakan pencitraan ultrasonografi untuk membantu keberhasilan blokade saraf femoralis. Metode penelitian adalah deskriptif analisis. Penelitian dilakukan terhadap 43 subjek sukarelawan berusia 18–60 tahun dengan indeks massa tubuh normal. Penelitian telah dilakukan bulan September–Oktober 2014 di Departemen Anestesiologi dan Terapi Intensif Fakultas Kedokteran Unpad dan Central Operating Theatre (COT) lantai 4 Rumah Sakit Dr. Hasan Sadikin Bandung. Analisis data menggunakan Uji Mann-Whitney dan uji t. Hasil penelitian, jarak rata-rata titik tengah arteri femoralis terhadap titik tengah saraf femoralis pada laki-laki  1,075±0,13 cm dan pada perempuan 1,069±0,13 cm. Simpulan penelitian, jarak arteri femoralis dan saraf femoralis 1,07 cm lateral terhadap arteri femoralis. Kata kunci: Blokade saraf femoralis, saraf femoralis, ultrasonografiDistance between Femoral Nerve and the Femoral Artery at the Level of Inguinal Crease with Ultrasound as a Guid for Femoral Nerve Block InjectionAbstractThe femoral nerve block is one the peripheral nerve block methods that are used to falicitate lower extremity surgical procedures. The advantages of femoral nerve block include an effective perioperative analgesia with minimum systemic side effects, lower dosage of opioids, early mobilization and cost effective. This study aimed to measure the distance from the mid point of the femoral nerve to the mid point of the femoral artery at the level of inguinal crease of adults with ultrasound guidance that will determine the success rate of femoral nerve block. A descriptive analytic study involving 43 volunteer subjects aged 18–60 years was performed at the Anesthesiology and Intensive Care Department of the Faculty of Medicine, Universitas Padjadjaran and Central Operating Theatre (COT) of Dr. Hasan Sadikin General Hospital Bandung between September and October 2014. Statistical analysis are using Mann-Whitney test and independent t-test. Results showed that the average distance from the mid point of the femoral nerve to the mid point of the femoral artery in male was 1.075±0.13 cm and in female was 1.069±0.13 cm. This study  conclude that the average distance of femoral artery to the femoral nerve is 1.07 cm lateral to the femoral artery. Key words: Femoral nerve, femoral nerve block, ultrasonography DOI: 10.15851/jap.v3n3.610
TATALAKSANA TETANUS GENERALISATA GRADE III YANG DISERTAI DENGAN COMMUNITY ACQUIRED PNEUMONIA DI RUANG PERAWATAN INTENSIF (LAPORAN KASUS) Nasution, Nur Intan; Sobaryati
E-Journal Widya Kesehatan dan Lingkungan Vol. 2 No. 2 (2020)
Publisher : E-Journal Widya Kesehatan dan Lingkungan

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Abstract

Tetanus is an acute toxemia due to neurotoxins produced by Clostridium tetani characterized by periodic and severe muscle rigidity and spasme, which threatens life and is world health problem. Goals of tetanus management include: (1) neutralization of unbound toxin; (2) eradication of tetanospasmin source; (3) muscle spasm control and treatment of autonomic dysfunction; and (4) general supportive management. The purpose of this paper is to report and describe the successful management of tetanus with complications due to muscle spasm, autonomic dysfunction and respiratory failure in intensive care unit. The method used is case report with retrospective approach and analyzed descriptively. Male, 34 years old, was admitted with complaints of wholebody rigidity 1 day before admission accompanied with trismus, dysphagia, hypertension, tachycardia, risus sardonikus, opistotonus and spasm of all muscles. Patient was diagnosed with tetanus generalisata grade 3 and admitted for 18 days in intensive care unit using mechanical ventilation. Tracheostomy was performed on the sixth day. The patient was fully recovered and discharged after 35 days of hospitalization. It can be concluded that tetanus mortality rate remains high because of its complications and longterm care for critical illness. Immediate diagnosis, identification of complications, complication management, and quality of supportive management are keys in determining outcome.